Thoracic Aortic Aneurysm Repair
The Vascular Center
Thoracic Aortic Aneurysm (TAA)
What is a thoracic aortic aneurysm?
A thoracic aortic aneurysm, also called TAA, is a bulging, weakened area in the wall of the aorta (the largest artery in the body), resulting in an abnormal widening or ballooning greater than 50 percent of the normal diameter (width).
The aorta extends upward from the top of the left ventricle of the heart in the chest area (ascending thoracic aorta), then curves like a candy cane (aortic arch) downward through the chest area (descending thoracic aorta) into the abdomen (abdominal aorta). The aorta delivers oxygenated blood pumped from the heart to the rest of the body.
An aneurysm can be characterized by its location, shape, and cause. A thoracic aortic aneurysm is located in the chest area. The thoracic aorta can be divided into segments: ascending aorta, aortic arch, and descending aorta, as described above. An aneurysm may be located in one of these areas and/or may be continuous throughout the aorta. An aneurysm called a thoracoabdominal aneurysm involves a thoracic aortic aneurysm extending down to the abdominal aorta.
Thoracic aneurysms do not occur as often as abdominal aneurysms. The descending thoracic aorta is the most common location of a thoracic aneurysm, followed by the ascending segment, then the arch. The location of an aneurysm is distinctly connected with the cause, course, and treatment of a thoracic aneurysm.
Thoracic aortic aneurysms are potentially even more dangerous than abdominal aortic aneurysms, as when they rupture, mortality is extremely high.
Thoracic Aortic Aneurysm Repair
Traditional TAA Repair
Traditional surgical repair is done via either an incision directly through the sternum, or an incision in the left chest, depending on the location of the aneurysm. Open surgical repair is sometimes the best and only option, but this approach can only be used for patients who are considered an acceptable surgical risk. This leaves many patients with no acceptable options for a repair.
Minimally Invasive TAA Repair
In March 2005, the U.S. Food and Drug Administration approved the first minimally-invasive endovascular device for the treatment of thoracic aneurysms. This device is known as the GORE TAG Thoracic Endoprosthesis. This device has been extremely successful, and opened the door for the development of additional thoracic endovascular devices.
Repair of thoracic aneurysms at Robert Wood Johnson University Hospital are now performed using either the Gore TAG Thoracic Endoprosthesis or the new Medtronic Talent Thoracic Aortic Graft.
Minimally invasive repair of TAA is usually performed through small incisions in the groin, avoiding the prolonged recovery time and complications from an incision through the chest wall. Minimally invasive repair has allowed vascular surgeons to offer treatment to many patients who were considered too high of a surgical risk for open surgery in the past.
A multidisciplinary approach is used at RWJUH, and frequently repairs of thoracic aneurysms require the expertise and combined skills of both our cardiothoracic surgical team and vascular surgical team. Both teams of surgeons are frequently involved with the planning and repair of these aneurysms, in both open surgical repair and endovascular repair.